Balloon Valvuloplasty also known as valvulotomy or valvotomy is a procedure done to open or widen a narrow or stiff (stenotic) heart valve. This procedure uses a balloon catheter to stretch the opening of your narrowed valve to allow more blood to flow through. This procedure provides temporary relief of symptoms. The most common cause of narrowing in the aortic valve is aortic valve stenosis.
Causes of Aortic stenosis
Problems that can cause aortic valve stenosis include:
- Calcium buildup on the aortic valve. As you age, calcium can build up on the valve, making it hard and thick. This buildup happens over time, so symptoms usually don't appear until after age 65.
- Congenital- heart defect born with
- Rheumatic fever or endocarditis. These infections can damage the valve.
Indications for Balloon Valvuloplasty
- Children and young adults: Balloon valvuloplasty is used successfully for children, and young adults who have symptoms due congenital heart defect e.g bicuspid valve
- Pregnant women: Valvuloplasty may be used for pregnant women who get aortic valve stenosis symptoms during pregnancy and cannot go in for surgery.
- As a stop-gap arrangement: If a person is too sick, valvuloplasty may be used until the patient can have the replacement procedure.
- Use for palliation- in patients with serious conditions that cannot be cured.
Symptoms of Valvular Stenosis
Aortic valve stenosis is a slow process. For many years, you will not feel any symptoms. But when the valve will become so narrow (often one-fourth of its normal size) you start having problems. Symptoms are often brought on by exercise when the heart has to work harder.
- Chest pain or pressure (angina)
- Fainting, Dizziness
- Easy fatigue
- Oedema swelling of feet
There is also have a high risk of sudden death.
Valve disease may be detected during a routine medical exam.
- On Auscultation -heart murmur, which is the sound of blood flowing across an abnormal heart valve. A murmur may be the first clinical sign of valve disease if you have no symptoms
- Echocardiogram: An echocardiogram or “echo” uses sound waves to create a picture of your heart. It shows the different structures of the heart and can show any abnormalities in your valves.
- Electrocardiogram (ECG),
- Your complete medical and surgical history noted
- The consultant will explain the procedure to you
- Inform if you are sensitive to or are allergic to any medicines, or have a history of bleeding disorders etc
- You will need to fast overnight before the procedure.
- Tell the doctor If you are pregnant or suspect you could be
- The physician may stop some of your medications or alter some dosage. Let your doctor know of all medicines and supplements that you are taking.
- You will be required to undergo routine tests before the procedure
- The procedure takes about 1-2 hrs
- (IV) line is inserted and vitals will be monitored during the procedure.
- A local anesthetic will be injected into the skin at the insertion site, you may be givensedatives to help relax.
- Your doctor will insert introducer, through an artery in the groin or arm
- Following which a thin flexible tube called a catheter is inserted through the introducer and threaded into the heart.
- Once the catheter is in place, your doctor will inject contrast dye to look at the area
- When the tube reaches the narrowed heart valve, a balloon at the end of the tube is inflated. Your doctor may inflate and deflate the balloon several times to open the valve.
- The balloon widens the valve opening.
- Once the valve has been opened, the doctor deflates the balloon and removes the catheter.
- The doctor will hold pressure on the insertion site. Once the bleeding has stopped, a very tight bandage will be placed on the site.
- You will be shifted to recovery room for observation .
- Bed rest may vary from 2 to 6 hours
- You will feel bruised where the catheter was inserted. This usually goes away in a few days.
- You may be given medicine for pain or discomfort
- You may resume your usual diet after the procedure
- It is important to keep the insertion site clean and dry
- It is important to make some lifestyle changes to keep your heart healthy, like, Quit smoking.
- Follow a heart-healthy diet and limit sodium.
- Be active. Ask your doctor what level and type of exercise is safe for you. You may need to avoid intense activity.
- Stay at a healthy weight, or lose weight if you need to.
Complications of Valvuloplasty include:
- Pain, swelling tenderness at catheter site
- Damage to valve causing immediate valve replacement
- Blood clot or damage to the blood vessel at the insertion site
- Abnormal heart rhythms
- New or worsening valve regurgitation
Factors Affecting Cost of Balloon Valvuloplasty
- The cost to the patient depends on a variety of factors like
- The hospital, the patient chooses.
- Fee for the team of doctors and OT charges
- Cost of procedure
- Standard test and diagnostic procedures
- Cost of the follow –up after the procedure